Weitzman Carol, Edmonds Diana, Davagnino Judith, Briggs-Gowan Margaret J
Yale School of Medicine.
Infant Ment Health J. 2014 Jan-Feb;35(1):1-9. doi: 10.1002/imhj.21421. Epub 2013 Nov 12.
Limited information is available about the rates and risk correlates of socioemotional/behavioral problems in young children in pediatric primary care settings serving low-income families. Our objective was to determine rates of clinically significant socioemotional/behavior problems in 12- to 48-month-olds from low-income families and identify associations between problems and individual and cumulative demographic and psychosocial risks. In this study, 378 Spanish- and English-speaking mothers attending a pediatric primary care practice serving low-income families were surveyed before well-child visits to assess socioemotional/behavioral problems (Brief Infant-Toddler Social-Emotional Assessment; M.J. Briggs-Gowan & A.S. Carter, ) and psychosocial and demographic risks (e.g., unemployment, low social support) (Parent Risk Questionnaire; D.I. Lowell, A.S. Carter, L. Godoy, B. Paulicin, & M.J. Briggs-Gowan, ). We found that 19.8% of children had clinically significant problems, and 53.2% experienced one or more psychosocial risks. Clinically significant socioemotional/behavioral problems were modestly to strongly associated with individual psychosocial risks, with the strongest associations with parental medical problems, parent depression/anxiety, and extreme parental distress, Adjusted Relative Risk (ARR) = 4.8-6.6, p < .0001. Cumulative demographic and psychosocial risk were uniquely associated with clinically significant problems, particularly among children experiencing three to four psychosocial risks, ARR = 3.0-11.6, p < .05. Psychosocial risks affect the majority of low-income families with young children, with a steep increase in likelihood of clinically significant socioemotional/behavioral problems as risks accumulate, underscoring the need to address both socioemotional/behavioral issues and psychosocial risk in young children.
在为低收入家庭提供服务的儿科初级保健机构中，关于幼儿社会情感/行为问题的发生率及其风险相关因素的信息有限。我们的目标是确定低收入家庭中12至48个月大儿童临床上显著的社会情感/行为问题的发生率，并确定这些问题与个体及累积的人口统计学和心理社会风险之间的关联。在本研究中，对378名在为低收入家庭提供服务的儿科初级保健机构就诊的讲西班牙语和英语的母亲进行了调查，在儿童健康检查前评估社会情感/行为问题（《婴幼儿社会情感简短评估》；M.J.布里格斯-高万和A.S.卡特）以及心理社会和人口统计学风险（例如，失业、社会支持低）（《父母风险问卷》；D.I.洛厄尔、A.S.卡特、L.戈多伊、B.保利辛和M.J.布里格斯-高万）。我们发现，19.8%的儿童存在临床上显著的问题，53.2%的儿童经历了一种或多种心理社会风险。临床上显著的社会情感/行为问题与个体心理社会风险呈中度至高度相关，与父母医疗问题、父母抑郁/焦虑以及父母极度痛苦的关联最强，调整相对风险（ARR）=4.8 - 6.6，p <.0001。累积的人口统计学和心理社会风险与临床上显著的问题存在独特关联，尤其是在经历三到四种心理社会风险的儿童中，ARR = 3.0 - 11.6，p <.05。心理社会风险影响了大多数有幼儿的低收入家庭，随着风险的累积，临床上显著的社会情感/行为问题的可能性急剧增加，这突出了在幼儿中解决社会情感/行为问题和心理社会风险的必要性。
